Russian Journal of Infection and ImmunityRussian Journal of Infection and ImmunityИнфекция и иммунитет2220-76192313-7398SPb RAACI1768410.15789/2220-7619-CIN-17684ORIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИResearch ArticleChanges in number, morphology and volume of platelets during neonatal sepsisИзменения количества, морфологии и объема тромбоцитов при неонатальном сепсисеZakerihamidiM.ЗакерихамидиМ.
Iran, Islamic Republic of

Associate Professor of Reproductive Health, Department of Midwifery, School of Medical Sciences

доктор философии (репродуктивное здоровье), доцент по специальности «Репродуктивное здоровье» кафедры акушерства Школы медицинских наук

boskabadih@mums.ac.irBoskabadiH.БоскабадиХасан
Iran, Islamic Republic of

Professor, Department of Pediatrics, Faculty of Medicine

профессор кафедры педиатрии, факультет медицины

boskabadih@mums.ac.irNayeriM.НаериМ.
Iran, Islamic Republic of

Neonatologist, Department of Pediatrics, Faculty of Medicine

врач-неонатолог, кафедра педиатрии, факультет медицины

boskabadih@mums.ac.irBadieeZ.БадиЗ.
Iran, Islamic Republic of

iatrics Hematologist, Department of Pediatrics, Faculty of Medicine

врач педиатр-гематолог, кафедра педиатрии, факультет медицины

boskabadih@mums.ac.irBagheriF.БагериФ.
Iran, Islamic Republic of

PhD Candidate in Nursing, Department of Nursing, Faculty of Nursing and Midwifery

аспирант сестринского дела, кафедра сестринского дела, факультет сестринского дела и акушерства

boskabadih@mums.ac.irAmirkhaniS.АмирханиС.
Iran, Islamic Republic of

Student of Midwifery, Department of Midwifery, School of Medical Sciences

студент, кафедра акушерства, Школа медицинских наук

boskabadih@mums.ac.irIslamic Azad UniversityИсламский университет АзадMashhad University of Medical SciencesУниверситет медицинских наук Мешхеда09092024300420251511521600606202416082024Copyright ©; 2025, Zakerihamidi M., Boskabadi H., Nayeri M., Badiee Z., Bagheri F., Amirkhani S.Copyright ©; 2025, Закерихамиди М., Боскабади Х., Наери М., Бади З., Багери Ф., Амирхани С.2025Zakerihamidi M., Boskabadi H., Nayeri M., Badiee Z., Bagheri F., Amirkhani S.Закерихамиди М., Боскабади Х., Наери М., Бади З., Багери Ф., Амирхани С.https://creativecommons.org/licenses/by/4.0https://iimmun.ru/iimm/article/view/17684

Introduction. Thrombocytopenia is considered as one of the signs of sepsis but, Changes in number, morphology and volume of platelets is not widely researched upon in this matter. Therefore, the current study is aiming to analyze the changes in number, morphology and volume of platelets during neonatal sepsis. Materials and methods. This cross-sectional study has been carried out on 807 premature neonates suspected to have infection in Ghaem hospital Mashhad from 2015–2023 by using available sampling method. The data collection tool, researcher-made checklist included laboratory evaluations by which platelet indicators [Platelet count, Platelet distribution width (PDW) and mean platelet volume (MPV)] were measured and compared before, during infection and after recovery. Afterwards, platelet characteristics in septic neonates (Case group) were compared to neonates without definite signs of infection (Control group). Results. Two hundred ninety-five neonates (35.5%) had definitive sepsis. In the case group the number of platelets was less and the amount of MPV and PDW were higher than control group. The number of platelets decreases during infection, but this numbers increase after recovery. PDW increases during infection and after recovery. Fifty four percent of infected neonates had thrombocytopenia. Thrombocytopenia in 78% of neonates with sepsis caused by Klebsiella pneumoniae and in 58% of the cases caused Enterobacter aerogenes was seen. The optimal cutoff value of platelet to differentiate case from those of control group was lower than 100 000/mcL, with a sensitivity of 73%, specificity 12.2% (AUC = 0.427), MPV more than 9.8(fl), with a sensitivity of 80%, specificity 47% (AUC = 0.618), PDW more than 11.2(fl), with a sensitivity of 90%, specificity 28.4% (AUC = 0.763). Conclusion. During infection the number of platelets decreases, but MPV and PDW increase. Thrombocytopenia was seen more in gram-negative bacteria rather than gram-positive. During infection the number of platelets decreases but after recovery the number of platelets, MPV and PDW increases. Platelet indices have good sensitivity but low specificity in diagnosing definitive infection.

Введение. Тромбоцитопения считается одним из признаков сепсиса, однако изменения количества, морфологии и объема тромбоцитов при этом изучены недостаточно. В этой связи настоящее исследование было посвящено анализу указанных изменений тромбоцитов при неонатальном сепсисе. Материалы и методы. Проведено поперечное исследование на 807 недоношенных новорожденных с подозрением на инфекцию в больнице Гаем в Мешхеде с 2015 по 2023 гг. с использованием доступного метода отбора проб. Форма учета результатов, составленная исследователями, содержала результаты лабораторных анализов, а именно показатели тромбоцитов [количество тромбоцитов, ширина распределения тромбоцитов (PDW) и средний объем тромбоцитов (MPV)] до, во время инфекции и после выздоровления. После этого характеристики тромбоцитов у новорожденных с сепсисом (основная группа) сравнивались с новорожденными без определенных признаков инфекции (контрольная группа). Результаты. У 295 новорожденных (35,5%) был диагностирован сепсис. В основной группе количество тромбоцитов было меньше, а уровень MPV и PDW был выше, чем в контрольной группе. Количество тромбоцитов уменьшается во время инфекции, но увеличивается после выздоровления. PDW увеличивается во время инфекции и после выздоровления. У 54% инфицированных новорожденных отмечена тромбоцитопения, при этом у 78% новорожденных сепсис был вызван Klebsiella pneumoniae, а в 58% случаев — Enterobacter aerogenes. Оптимальное пороговое значение тромбоцитов для различий между основной и контрольной группами было ниже 100 000/мкл, с чувствительностью 73%, специфичностью 12,2% (AUC = 0,427), MPV более 9,8 (fl), с чувствительностью 80%, специфичностью 47% (AUC = 0,618), PDW более 11,2 (fl), с чувствительностью 90%, специфичностью 28,4% (AUC = 0,763). Заключение. Во время неонатального сепсиса количество тромбоцитов уменьшается, но уровни MPV и PDW увеличиваются. Тромбоцитопения чаще наблюдалась при патологии, вызванной грамотрицательными чем грамположительными бактериями. Во время инфекции количество тромбоцитов уменьшается, однако после выздоровления количество тромбоцитов, MPV и PDW увеличивается. При диагностике типичной инфекции индексы тромбоцитов показали хорошую чувствительность, но низкую специфичность.

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